Medication non-adherence is a significant problem in healthcare that results in suboptimal treatment outcomes and increased healthcare costs. To deal with this problem, a complex view of the determinants of patient behavior is needed. In this context, the integration of theoretical frameworks becomes crucial. In light of this statement, this paper presents a theoretical framework derived from Social Cognitive Theory (SCT) and the Health Belief Model (HBM) to guide interventions to enhance medication adherence among patients in primary care settings.
Social Cognitive Theory (SCT)
Process and Logic Selection: SCT concerns the bidirectional effects of personal factors, environmental influences, and behavior. It was selected for this study as it incorporates a complete cognitive model to explain how health habits like medication adherence are influenced by individuals’ cognitions, self-efficacy and social environments (Unni & Bae, 2022).
Application to the Project: SCT claims that people are more likely to follow their medication regimens if they have efficacy and believe from the adherence that some positive outcomes exist. Furthermore, by watching and learning from healthcare providers and peers who successfully manage their medications, one will improve his/her self-efficacy and motivation to comply.
Assumptions: SCT presumes that behaviour is a result of the parent’s beliefs, values, and attitudes and the characteristics of the environment.
Key Components: Self-efficacy, outcome expectancies, vicarious learning, and operant conditioning.
Application to the Phenomenon: According to the model, interventions that improve patients’ self-efficacy, which will add positive reinforcement for adherence and transform the social environment into support, can help medication adherence.
Health Belief Model (HBM)
Process and Logic Selection: HBM concentrates on what people think about the danger posed by a health problem, the gains anticipated from action, and the impediments to action (Punlomso et al., 2020). It was selected because it yields insights into cognitive issues determining health-related choices.
Application to the Project: Patients are likely to stick to their medication regimen if they believe themselves to be susceptible to the bad outcomes of non-adherence, such as the worsening of health conditions, think that adherence is effective in eliminating the threat, and deem few to no barriers to adherence.
Assumptions: HBM postulates that people evaluate health problems concerning the advantages and barriers to health behaviors.
Key Components: Perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy.
Application to the Phenomenon: The framework proposes that interventions should target improving patients’ perceptions of their condition’s severity, the benefits of adherence, and their confidence in adhering, notwithstanding the existing barriers.
Rationale for Sample Selection Criteria
Sample selection criteria should mirror the population most relevant to the phenomenon under study. Here, the sample might have patients with chronic conditions that require drug administration in a generalist practice setup. Other characteristics like age, health literacy, socioeconomic status, and previous adherence behavior can be likewise considered for a diverse and representative sample.
Analysis of Pertinent Research
Previous research that used SCT and HBM for medication adherence has shown promising results. The effectiveness of treatments based on these theories has been proven; they have been shown to raise patients’ adherence rates and health outcomes (Abdulrahman et al., 2019). Nevertheless, self-report bias and difficulty measuring behavioral change should be noted, and further research should address these limitations.
Conclusion
Social Cognitive Theory and Health Belief Model are integrated into the theoretical/conceptual framework, depicting comprehensively the role of the factors that affect patients’ medication adherence in a primary care setting. By exploring the assumptions, critical constructs, and implementation of each theory to the phenomenon under study, researchers can create interventions to improve patient adherence and overall healthcare outcomes.
References
Abdulrahman, S. A., Ganasegeran, K., Rampal, L., & Martins, O. F. (2019). Conceptual Framework for Investigating and Influencing Adherence Behavior among HIV-Positive Populations: An Applied Social Cognition Model. AIDS reviews, 21(3).
Punlomso, S., Srimuang, P., & Tudpor, K. (2020). Fall prevention by Otago exercise program based on health belief model in community-dwelling older persons. Indian Journal of Physiotherapy and Occupational Therapy, 14(1), 245-252.
Unni, E., & Bae, S. (2022). Exploring a New Theoretical Model to explain the behavior of Medication Adherence. Pharmacy, 10(2), 43.
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